Injury and Fall Prevention Starts with the Feet

The feet are often overlooked as a contributing factor to leg pain and injury. The foot receives and distributes the weight of the body during movement. Poor alignment or improper footwear can potentially create problems with the ankle, knee, hip, and pelvis. For example, people with flat feet or excessive pronation (turning inward of the instep) can have inward rotation of the legs, which can aggravate bursitis, or arthritis of the ankle, knee and hip. Increased pressure over vulnerable structures of the foot can lead to conditions such as plantar fasciitis (pain along the instep), heel spurs, stress fractures and Achilles tendonitis. Improving the alignment of the foot can be accomplished with proper footwear, insoles/orthotics and flexibility/strengthening exercises.
In order to stay active, proper footwear is crucial. Shoes and socks contribute to absorbing the “shock” on the foot and leg. Decreasing the force on the lower limbs lessens the risk of injury or developing chronic conditions such as osteoarthritis. Shoe stores now offer a variety of shoes for most activities. It can be confusing trying to sort out the correct shoe for you. For walkers, it is important to get a walking or running shoe with stability, heel and arch support, and the appropriate amount of stiffness/flexibility. For hikers, a hiking boot or shoe with good traction and ankle support should be used. When choosing footwear consider the following criteria:
1) Sizes vary; judge the shoe by how it fits your foot. Feet often
get larger with age.
2) Have both feet measured and fit the larger foot.
3) Try shoes on at the end of the day when your feet are largest.
4) Stand during the fitting process and allow 1/2 inch space at
the end of the shoe for your longest toe and ample width.
5) Spend time walking in the shoe to check for minimal heel
slippage and to make sure it fits comfortably.
For those with “hard-to-fit” feet or special footwear requirements, a pedorthist (footwear specialist) can assist you. For further information contact the Pedorthic Footwear Association at 800-673-8447. For a foot evaluation, there are multiple excellent Podiatrists (foot doctors), and Orthopedists locally who specialize in foot and ankle conditions. Active individuals should replace their fitness shies every 6-9 months since up to 60% of the shock absorption capability diminishes after regular usage.
Other than proper footwear, specific exercises can prevent foot problems. The supportive soft tissue structures of the foot require routine stretching and strengthening exercises. To prevent falls, twisting the ankle and over-use injuries, movements that improve the stabilization of the foot and ankle and include balance exercises are helpful. Proper warm-up is also important before exercise and other activities. For guidelines of appropriate exercises contact a physical therapist, personal trainer or other health care professional specializing in the field.
Since you cannot walk on your hands as alternative, invest in proper footwear and treatment for the feet to keep you walking and active.

Carol Penfield RN, MS, NPc., is a nurse practitioner, personal trainer and program director at the Chatham Health and Swim Club. Her office phone number is 508-945-7761.